NURS 201 - Endocrine(1).pptx - Endocrine Christine Garcia...

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Endocrine Christine Garcia, MSN, ARNP, FNP-BC
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Function of the Thyroid Gland The thyroid gland plays a major role in metabolism, growth and development of the human body Helps regulate many body functions by constantly releasing a steady amount of thyroid hormone into the bloodstream Produces, stores and releases hormone into the blood stream Uses iodine from the food we eat to make two main hormones (T3, T4) Regulate vital body functions, including: Breathing Heart rate Central and peripheral nervous systems Body weight Muscle strength Menstrual cycles› Body temperature Cholesterol levels
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Hyperthyroidism Hyperactive thyroid gland with increase in synthesis and release of thyroid hormones Decreased TSH, Elevated T3, T4 Occurs in women more than men Most common form of hyperthyroidism is Grave’s disease Other causes include toxic nodular goiter, thyroiditis, excess iodine intake, pituitary tumors, and thyroid cancer May be precipitated by iodinated contrast media used in CT scans and other radiological studies Thyrotoxicosis – physiological effects or clinical syndrome of hyper metabolism resulting in excess circulating T3, T4 or both
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Graves Disease Autoimmune disease of unknown etiology characterized by diffuse thyroid enlargement and excess thyroid hormone secretion Accounts for 75% of the cases of hyperthyroidism Precipitating factors include: insufficient iodine supply, cigarette smoking, infection, and stressful life events may interact with genetic factors to cause Graves Disease Patient develop antibodies to the TSH receptor, these antibodies attach to the receptors and stimulate the thyroid gland to release T3, T4 or both. The excess release of thyroid hormone leads to the clinical manifestations associated with Thyrotoxicosis
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Clinical Manifestations of Graves Disease Related to excess circulating thyroid hormone Palpitations Exophthalmos (protrusion of eyeballs) Weight loss Nervousness, restlessness, irritability Acropachy (clubbing of the digits) Heat intolerance Irregular menstruation
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Diagnostics Thyroid stimulating hormone (TSH) – Low or undetectable (<0.4mU/L) & Free Thyroxine (Free T4) – Elevated confirm diagnosis. Total T3 & T4 levels may be assessed by not definitive Radioactive Iodine Uptake Test (RAIU) - test used to differentiate Graves Dz from other forms of thyroiditis; patients with Graves Dz show an uptake of 35%-95%, patients with Thyroiditis show an uptake of <2%
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Management of Hyperthyroidism Goal is to block the adverse effects of excessive thyroid hormone, suppress over secretion of thyroid hormone, and prevent complications Drug/Medications: Anti-thyroid drugs, Iodine, and B-adrenergic blockers (NOT consider curative) Propylthiouracil (PTU) and Methiazole (Tapazole) – inhibit synthesis of thyroid hormone PTU used in pregnant women to control symptoms until surgery or radiation (who have had a reaction to Methiazole or require rapid reduction of symptoms)
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